Allum John Hj, Carpenter Mark G
Department of ORL, University Hospital, Basel, Switzerland.
Curr Opin Neurol. 2005 Feb;18(1):15-21. doi: 10.1097/00019052-200502000-00005.
Falls are a serious problem for the elderly and others prone to fall. In particular, those over 65 years of age will suffer at least one fall a year and as a result will need cost-intensive medical treatment. Under these circumstances, an optimal clinical pathway should first identify those with a tendency to fall, second, pinpoint the disease-specific deficits in balance control and walking patterns, and third, offer the possibility through focused biofeedback training to reduce the number of falls suffered. This review describes new methods of assessing balance control in both static and dynamic balance conditions and their applications for balance rehabilitation.
Technological advances and applied research have shown that body-worn sensors measuring angular velocity (gyroscopes) or the acceleration of the trunk can effectively quantify balance during stance and gait tasks, and can be used to detect potential fallers and discriminate between different balance disorders. Standing on foam support reveals balance deficits regardless of the underlying disease. Disease-specific balance deficits can be characterized by the pattern of trunk movements between various semi-stance and gait tasks. Angular velocity sensors have recently been shown to provide highly relevant information for use as biofeedback, or as an ambulatory device to record balance and gait performance over long periods of time in both clinical and natural living conditions.
Angular velocity sensors can provide balance-relevant information directly to the clinician, and provide an important improvement on the complicated and time/cost-intensive techniques of traditional balance measurement systems.
跌倒对于老年人及其他易跌倒人群而言是一个严重问题。尤其是65岁以上的老人每年至少会跌倒一次,因而需要花费高昂成本进行医学治疗。在这种情况下,最佳临床路径应首先识别出有跌倒倾向的人群,其次,明确平衡控制和行走模式中特定疾病导致的缺陷,第三,通过有针对性的生物反馈训练减少跌倒次数。本综述介绍了在静态和动态平衡条件下评估平衡控制的新方法及其在平衡康复中的应用。
技术进步和应用研究表明,测量角速度(陀螺仪)或躯干加速度的可穿戴式传感器能够有效量化站立和步态任务期间的平衡情况,可用于检测潜在的跌倒者,并区分不同的平衡障碍。站在泡沫支撑物上能揭示平衡缺陷,而与潜在疾病无关。特定疾病的平衡缺陷可通过各种半站立和步态任务之间的躯干运动模式来表征。最近研究表明,角速度传感器可提供高度相关的信息,用作生物反馈,或作为一种移动设备,在临床和自然生活条件下长时间记录平衡和步态表现。
角速度传感器可直接为临床医生提供与平衡相关的信息,相较于传统平衡测量系统复杂且耗时/成本高昂的技术有了重要改进。